Risk Factors Associated With Neurosurgical Intervention in Patients With Mild Traumatic Intracranial Hemorrhage

Community centers commonly transfer patients with traumatic intracranial hemorrhage (ICH) to level 1 and 2 trauma centers for neurosurgical evaluation regardless of the degree of injury. Determining risk factors leading to neurosurgical intervention (NSI) may reduce morbidity and mortality of trauma...

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Bibliographic Details
Published in:The Journal of surgical research 2023-03, Vol.283, p.137-145
Main Authors: Patel, Puja D., Broadwin, Mark, Stansbury, Tara, Brown, Jeffrey B., Kincaid, Hope, Duka, Shae, Pasquale, Justin, Cipolle, Mark, Shah, Kamalesh
Format: Article
Language:English
Subjects:
Female
Glasgow Coma Scale
Hematoma, Subdural
Humans
Intracranial hemorrhage
Intracranial Hemorrhage, Traumatic
Male
Neurosurgery
Neurosurgical intervention
Neurosurgical Procedures
Retrospective Studies
Risk Factors
Subarachnoid hemorrhage
Subdural hemorrhage
Trauma
Trauma Centers
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Summary:Community centers commonly transfer patients with traumatic intracranial hemorrhage (ICH) to level 1 and 2 trauma centers for neurosurgical evaluation regardless of the degree of injury. Determining risk factors leading to neurosurgical intervention (NSI) may reduce morbidity and mortality of traumatic ICH and the transfer of patients with lower risk of NSI. A retrospective chart review was performed on patients admitted or transferred to a level 1 trauma center from October 2015 to September 2019 with Glassgow Coma Scale score 13-15 and traumatic ICH on initial head computerized tomography (CTH) scan. Bivariate analyses and multivariable regression were used to identify factors associated with progression to NSI. Of 1542 included patients, 8.2% required NSI. A greater proportion were male (69.1% versus 52.3%, P = 0.0003), on warfarin (37.7% versus 21.6%, P = 0.0023), presented with subdural hemorrhage (98.4% versus 63.3%, P 
ISSN:0022-4804
1095-8673
DOI:10.1016/j.jss.2022.10.042